C09995528 / invoice 10000

Reason: Follow-Up (Stopped Medication)Appointment Notes: MGLHistory:Constantly rotating/bucking his head, licking and swallowing throughout the day and night. No vomiting or diarrhoea. OR increasing anxiety/separation anxiety, sticking to Os side all day. Presented in August 2025 for chronic obsessive licking around mouth/swallowing, rDVM diagnosed chronic orofacial pain syndrome and was referred to internal medicine team for second opinion. First presented problem to rDVM in Jan 2025 and they in case was related to dental dz - had O was told 2 more teeth had to be removed. CT head/neck + upper GIT endoscopy/biopsy performed. Biospies from hard palate revealed ulcerative eosinophilic to mixed stomatitis suggestive of canine eosinophilic granuloma complex (EGC). Treated with 50mg Cyclosporine PO q12h x 10d then 30mg PO q24h ongoing & 10mg Pred PO. Re-presented September 2025 for profound PU/PD and inappropriate urination and panting heavily since commencing on pred. Pred was reduced from 10mg to 5mg PO q48h. Vitamin B12 measured October 2025......163pmol/L (99-503) Phenobarb (trialled in case related to seizure activity) stopped October 2025 and cobalazorb commenced - 1 capsule PO q24h Current diet: gluten-free rice + crumbed schnitzel chicken Current medications: stopped both meds 1 week ago to see if anything would changed 5mg Prednisolone PO q48h 1 capsule Cobalazorb PO q24hSubjective:BARObjective:HRAssessment:Plan:- PetDentistry for dental procedure- Stop prednisolone as ulcer healed - Stop gluten free diet    Vital Signs    Weight: 10;